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Changing health care
to improve quality of
life for all.

Beth Israel Lahey Health’s roots in providing top-quality health care date back nearly a century. We're fully committed to ensuring our patients receive the care they deserve. As a leading healthcare provider throughout New England, we aim to change the current state of health care for the better and make lasting improvements that guarantee access to our services.

Executive Director, Net Revenue & Reimbursement

Charlestown, Massachusetts

Organization Facility: Beth Israel Lahey Health - Non Executive Category: General Finance Job ID: JR54524 Date posted: 06/13/2024
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Job Type: Regular

Time Type: Full time

Work Shift: Day (United States of America)

FLSA Status: Exempt

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

The Executive Director at Beth Israel Lahey Health (BILH) will play a crucial role in the revenue finance management within the organization. BILH is a new integrated health system with ~$6 billion in revenues and includes academic medical centers, acute and specialty hospitals, outpatient facilities, physician groups and performance networks. The Executive Director will report directly to the Vice President of Reimbursement.


In this capacity, the Executive Director will assist the VP in merging BILH’s six individual revenue valuation and reimbursement units into a centralized, system-wide department that promotes uniform goals and efficiency. The key responsibilities of the Executive Director will include:

• Ensuring the delivery of high-quality net revenue valuation and related financial models, employing transparent and efficient methodologies.
• Providing data and analytics that yield actionable insights for decision-makers across BILH’s network of hospitals, physicians, and systems.
• Formulating strategic solutions to enhance reimbursement processes, leveraging extensive knowledge of both governmental and commercial payment systems.
• Contributing Medicare, Medicaid, and payment system expertise to aid BILH’s strategic and operational goals.


The Executive Director will have a 14+ – member staff including Directors, Managers and Financial Analysts, with 2 direct reports. The Executive Director will actively manage and influence BILH’s $5.3 billion in net revenues and participate in the design and implementation of reimbursement optimization strategies across the system.


The Executive Director will also be responsible for collaborating with hospital and system leadership to ensure the effectiveness of these strategies and will oversee a dedicated team focused on revenue valuation and reimbursement processes. This role demands meticulous attention to maintaining compliance and efficiency in all revenue-related operations within the system.


Responsibilities include overseeing the implementation and conversion to RCA Crowe’s revenue valuation technology, and establishing reserve methodologies, third-party and other revenue accounting policies. Additionally, the Executive Director will develop the internal audit and other practices to ensure sustainability and adherence to enterprise policies and procedures. The Executive Director will also be responsible for ensuring all routine revenue valuation functions are appropriately resourced, and identify opportunities to improve the accuracy and/or efficiency of all related activities.

Job Description:

Essential Duties & Responsibilities including but not limited to: 

1.    Communicate the department’s vision and goals and ensure employees can relate them to their team and individual goals.  Provide day to day management including creating departmental goals and objectives, developing performance standards, and motivating and engaging the team to achieve goals.
2.    Lead BILH-wide strategic initiatives to optimize revenues in partnership with the BILH Finance leadership team.  Educate and engage cross-functional leaders, including hospital CFOs, Finance leaders, Revenue Cycle teams, and Contracting.
3.    Maintain focus on appropriate optimization opportunities across the system, and foster a comprehensive, ROI-driven approach to BILH’s prioritization of enterprise-level revenue opportunities.
4.    Serve as department leader engaging with government officials regarding BILH’s $2.7 billion in government reimbursements, including representing BILH in all audits, investigations, etc.
5.    Lead the development of an enterprise-wide revenue valuation methodology, including the implementation of the RCA Crowe platform across all BILH hospital facilities. 
6.    Ensure the department maintains a disciplined approach to updating reserve tool tables, reviewing reserve models, reviewing journal entries, reviewing general ledger account reconciliations, analyzing variances, and resolving issues.
7.    Provide oversight to the accounts receivable reserving process to include proactive monthly, quarterly, and analytical reviews of reserve levels and trends, standardization of practices and development of System-wide policies
8.    Prepare and present to senior management team the monthly net revenue estimates and proposed third party entries for hospital and professional business units
9.    Develop and manage the preparation and analysis of reports designed to monitor net revenue and identify trends in net revenue for hospital and professional business units
10.    Oversee the completion of  the annual net revenue budget and assist with forecasting processes for net revenue projections for hospital and professional business units
11.    Lead contact with external and internal audits surrounding accounts receivable and net patient revenue, including but not limited to net patient accounts receivable hindsight analyses
12.    Partner with the Strategic Reimbursement group to design and implement BILH’s strategic reimbursement initiatives. Additionally, ensure the Revenue Finance team has the resources and training to assist in the preparation and filing of the Medicare and Medicaid cost reports, etc.
13.    Develop and maintain a close working relationship with operational and financial associates to foster teamwork, effective communication, and cohesiveness regarding financial matters


Minimum Qualifications: 
Education:    Bachelor’s Degree in Accounting or Finance or related fields. 


Licensure, Certification & Registration:    
N/A


Experience:

  • 7-10 years of progressively increasing healthcare finance experience; including 5+ years in healthcare revenue-focused roles, such as net revenue, government reimbursement, revenue cycle, etc.
  • 5+ years of managerial experience, including experience as a leader of leaders with a demonstrated ability to build cohesive and motivated teams that have a discipline of excellence.
  • Experience as a federal, state, or external healthcare auditor preferable

Skills, Knowledge & Abilities:

  • Extensive healthcare reimbursement experience
  • Must be able to handle multiple, complex tasks and priorities
  • Requires superior interpersonal skills to effectively supervise staff and
  • work and communicate with all levels of management
  • Must be a highly self-motivated individual with the ability to function in a
  • fast-paced environment with limited supervision and direction
  • Must have strong analytical skills
  • Must be able to effectively mentor staff and foster a supportive and
  • growth-oriented environment
  • Must have superior computer skills on various software products 
  • and systems including MS Office, HFS, EPIC, and Crowe (not required)
  • Must be a dedicated team player with the willingness and desire to learn and grow within the organization.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled

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Why join Beth Israel Lahey Health?

If you’re looking for a career where you can make a difference and explore your potential, Beth Israel Lahey Health is the place you belong. Our system includes a network of hospitals, physician practices, outpatient centers, and other healthcare facilities and we offer a broad range of careers in direct patient care, environmental services, registration, finance and many other fields. We are focused on providing compassionate and personalized healthcare with a strong reputation for clinical excellence and research and offer diverse opportunities for career growth and development. Conveniently, we have many locations in communities across Eastern Massachusetts and Southern New Hampshire.

At Beth Israel Lahey Health, we see you for all that you are – your experience and your dreams. Explore our open opportunities and find out why so many have already chosen to join our team.

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